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Twelve workers with hard metal asthma diagnosed on the basis of peak flow diaries and positive bronchial reactions to cobalt chloride (CoCl2) were studied for sensitization by detection of specific antibodies to radioactive cobalt (57Co), cobalt-conjugated human serum albumin (Co-HSA) and cobalt-conjugated exchange resin (Co-resin). Their IgE titres ranged from 73 to 1500 IU/ml and eight were atopic individuals. Sixty serum samples from asthmatic patients with IgE titres of 14-4300 IU/ml were studied as controls in all tests. Eleven of twelve subject sera that selectively bound to 57Co after incubation with saturated ammonium sulphate (greater than 232 c.p.m., P less than 0.01) were divided into three groups: (1) six sera showing evidence of specific IgE antibodies to Co-HSA (greater than 673 c.p.m., P less than 0.01) without those to Co-resin; (2) one serum giving a positive radio-allergosorbent test (RAST) only to Co-resin (greater than 417 c.p.m., P less than 0.01), and (3) four sera that were negative for two antigenic agents (Co-HSA, Co-resin). These results suggest that the subjects had occupational asthma due to hard metal exposure from cobalt sensitivity. An immuno-allergic mechanism mediated by specific IgE antibodies to cobalt was confirmed to be responsible for the development of hard metal asthma, with the possibility of some role of the reaction without reagins.

The specific red cell adherence (SRCA) test for blood group antigens was used in 32 patients with upper urinary tract tumours to determine whether their survival could be predicted by this test. The SRCA results correlated well with survival in each grade and stage of the tumours. Overall, patients with positive tests showed a significantly higher 5-year survival rate than those with negative tests (87.2% vs. 24.6%). These findings add support to the prognostic importance of this test in upper urinary tract tumours.

For the purpose of carrying out an objective evaluation of the clinical efficacy and safety of cefotetan (CTT), a new cephamycin-type injectable antibiotic, in the treatment of complicated urinary tract infections, cefmetazole (CMZ) was employed as the control drug in a comparative study performed by the double-blind method. CTT was administered in a dose of 0.5 g or 1 g, while CMZ was used in a dose of 1 g; both of these drugs were administered by intravenous drip infusion twice a day for 5 days. The total number of treated cases was 393; 105 patients in the CTT 1 g group, 97 patients in the CTT 2 g group, and 96 patients in the CMZ 2 g group. The judgment of the clinical effects of these 3 therapeutic regimens was carried out in accordance with the criteria for evaluation of clinical efficacy of antimicrobial agents on UTI (2nd edition). The results are as follows. With regard to the overall efficacy of the drug treatments, the calculated efficacy rates were 54.3% in the CTT 1 g group, 63.9% in the CTT 2 g group and 52.1% in the CMZ 2 g group. The differences between these efficacy rates were not statistically significant. Regarding the efficacy of the treatments in terms of the bacteriuria, the bacterial cultures were seen to become negative in 40% of the cases in the CTT 1 g group, 54.6% of the CTT 2 g group and 42.7% of the CMZ 2 g group. Again, there were no statistically significant differences between the groups. Concerning the efficacy of the drugs against pyuria, by combining the cases found to be normalized and those seen to show improvement, the improvement rates were calculated to be 41.9% for the CTT 1 g group, 37.1% for the CTT 2 g group, and 37.5% for the CMZ 2 g group. These pyuria improvement rates show no statistically significant differences, respectively. The incidences of occurrence of side effects and laboratory test abnormalities thought to be caused by the drug therapy were as follows; 1.5% and 5.3% in the CTT 1 g group, 1.5% and 3.1% in the CTT 2 g group and 0% and 6.9% in the CMZ 2 g group. There were no significant differences between the groups. Based on the above clinical results, it can be concluded that, in the treatment of complicated urinary tract infections, we can expect CTT to provide the same therapeutic efficacy as CMZ when its dosage is the same or even half thereof. In addition, the safety of CTT is equal to that of CMZ. Therefore, CTT is concluded to be a useful drug.

Gentamicin 40 mg was intramuscularly admininistered two times daily to 15 patients with complicated urinary tract infections. The results are as follows 1. The clinical efficacy of gentamicin was excellent in 12 cases (80.0%), good in 2 cases (13.3%) and null in 1 case (6.7%). The effective rate was 93.3%. 2. Bacteria disappeared in 16 strains (84.2%), colonized in 3 strains (15.8%) out of 19 isolates. 3. BUN, GOT and GPT values were determined before and after GM administration, and no significant abnormal finding attributable to GM was observed in this clinical study.

We performed a controlled double-blind clinical study with PMPC to investigate its therapeutic usefulness in acute simple cystitis in comparison with NA, with the results as follows: 1. In both treatment groups, PMPC proved to be remarkably more active (MIC) than NA against the bacterial isolates tested in vitro. 2. PMPC, administered in dosis (200 mg per day) one-tenth those of NA (2,000 mg per day), produced a greater improvement (therapeutic effects) than NA. 3. Side-effects were apparently less frequent with PMPC, as compared to NA. The results indicate a remarkable usefulness of PMPC in the treatment of acute simple cystitis.

Patients with chronic complicated urinary tract polymicrobial infections due to Pseudomonas aeruginosa and other bacteria were treated with cefsulodin using cefotiam or cefmenoxime as a concomitant drug. Each drug was given to the patients in daily dose of 1 or 2 g by drip infusion twice a day for 5 to 16 days. The results were as follows: Overall clinical efficacy was excellent in 7 cases (44%), moderate in 6 cases (38%) and poor in 3 cases (19%), the effectiveness rate being 81.3%. Bacteriologically, 38 strains (88.4%) were eradicated, 1 strain decreased and 4 strains unchanged out of the 43 clinical isolates from the patients. No side effects and no abnormalities of laboratory findings were observed.

A 71-year-old man presented with an unusual adrenal tumour. Computed tomography and echography showed a large, necrotic mass with multiple calcifications. Preoperative angiography demonstrated pooling of contrast medium within the mass, strongly suggestive of a diagnosis of haemangioma.

Idiopathic pulmonary fibrosis (IPF) and interstitial pneumonia associated with collagen vascular disease have been shown to be difficult to differentiate by clinical, roentgenological, pathological and immunological findings. We have applied the analysis of BALF T cell phenotypes to these two groups by enumerating the cell populations of OKT4+ and OKT8+ cells in BALF and, as a result, have been able to discern a clear and meaningful differentiating point between the two groups. In all 9 patients with IPF were examined in whom OKT4+ cells outnumbered OKT8+ cells in BALF T cell subsets, while 13 patients with collagen vascular disease were tested (3 SLE, 6 RA, 2 Sjögren's syndrom and 2 MCTD) in whom OKT8+ cells were more numerous than OKT4+ cells. No difference was observed in blood T lymphocytes between these two groups. These results provide us with a means of differentiation between these groups, especially in clinically borderline cases.

The diagnosis of renal dysplasia associated with a single vaginal ectopic ureter is often difficult, because the dysplastic kidney is usually not seen on excretory urography. A 17-year-old girl, whose affected kidney was accurately identified by computed tomography, is reported. Computed tomography is a useful technique for the diagnosis of renal dysplasia with a single vaginal ectopic ureter.

Unlabelled: Recently, the scintigram with 99mTc-labeled compounds has been routine procedure, because of it's ideal physical characteristics. The short physical half life of six hours, the absence of beta emission, and the gamma rays of 140 keV permit the administration of large amount of radioactivity. For scintigram of deep or large organ, the absorption of 99mTc gamma-rays by bone and soft tissue should not be negligible. For example, bone scintigram with 99mTc-phosphorous compounds shows different pictures depending upon the anterior and the posterior views, because of it's rather lower energy. Therefore, the linear attenuation coefficient and the half value layer of bone and soft tissue were measured with 99mTc gamma-rays and others (197Hg, 203Hg, 131I, 198Au, 85Sr)., Results: 1) The linear attenuation coefficient of 99mTc gamma-rays was: bone -0.240 cm-1, acrylite -0.173 cm-1, Mix D -0.155 cm-1. 2) The half value layer of 99mTc gamma-rays was: bone -2.89 cm, acrylite -3.98 cm, Mix D -4.47 cm. It was concluded that the lower photon energy of 99mTc was influenced by bone and soft tissue, but it appeared to be most suitable for the present imaging devices. Therefore, pictures of multiple views are necessary in case of the scintigram was 99mTc-labeled compounds.

We have constructed compensating screens which have different sensitivities for the pulmonary hilum and mediastinum in contrast to the lung. With these screens the regions of the mediastinal and retrocardiac areas are simultaneously displayed with optimal contrast on postero-anterior (PA) chest radiographs. The potential clinical use of compensating screens was evaluated in 67 patients for visibility of the anatomical structures in comparison with conventional screens. Confidence test was used to compare the detectability of the various anatomical structures of the chest. The chest radiographs obtained with compensating screens improved visibility of the anatomical structures including the tracheal bifurcation, right and left main bronchus, and paraesophageal line.

A new in vitro method was developed which enabled isolation and identification of ACB-positive bacteria in polymicrobial renal bacteriuria. This approach was used in 16 patients with permanent nephrostomies and asymptomatic bacteriuria who had shown positive ACB test by the method of Thomas et al. A total of 48 urinary isolates were obtained from these patients in which 21 (43.8%) were revealed as being positive by the present method. In 13 of the 16 patients, there was only one positive species among several species of bacteria. The species with a colony count of more than 10(5)/ml was found to be most commonly ACB positive (71.5%). Of the 13 patients who had creatinine clearance tests available, 11 (84.6%) showed a considerable decrease in renal function after the intervals since nephrostomy. The immunologically different characteristics observed among multiple bacterial species in polymicrobial renal bacteriuria suggest a possible aggressive role for the ACB-positive species and therefore a need for eradicating them.

Transcatheter embolization of the hepatic artery for hepatomas was performed with the use of Gelfoam and Lipiodol-ADM in 98 patients (Gelfoam 63 patients; Lipiodol-ADM 35 patients). The cumulative one-year survival rate was 52.9% for the Gelfoam group and 28% for the Lipiodol-ADM group. Response to hepatic embolization was most remarkable in the nodular type; CR was obtained in five patients and PR in 31 patients (response rate: CR + PR = 57.1%) in the Gelfoam group, with no CR and six PRs (response rate, 17.6%) in the Lipiodol-ADM group. Alfa-feto protein (AFP) decrease of more than 50% was observed in 78.1% of the Gelfoam group and 40% of the Lipiodol-ADM group. The side effects were transient and controlled with conservative treatment. Gelfoam seemed to be more effective in the treatment of hepatoma, but the damage to normal tissue was more severe with this embolic material.

Eight asthmatic patients who had no history of asthma before starting work in a hard-metal plant and eight control subjects (three atopic, three nonatopic asthmatic, and two normal volunteers) without a history of exposure to hard metal dust were subjected to provocation tests, skin tests, radioallergosorbent tests (RAST) and Farr test with cobalt. Four of the eight patients were atopic, and seven showed bronchial hyperresponsiveness to methacholine (BHR). Patch and intradermal skin tests with cobalt chloride (CoCl2) could not discriminate the patients from control subjects. All patients had positive reactions to CoCl2 in the provocation tests; two developed immediate asthmatic reaction (IAR), four late asthmatic reaction (LAR), and two dual asthmatic reaction (DAR), while the control subjects showed no reaction. Evidence of specific IgE antibodies to cobalt-conjugated human serum albumin (Co-HSA) was presented by four patients (RAST score greater than 2) based on comparison of serum samples from 60 asthmatic patients and 25 asymptomatic workers in the same plant. Positive serum samples selectively bound 57Co, and the test was blocked by nonlabled cobalt sulfate (CoSO4). These findings suggest the development of hard metal-induced asthma from cobalt sensitivity.

A direct immunofluorescence method was used to detect A, B, or H blood group isoantigens in deparaffinized tissue sections of 30 bladder tumors of various grades and stages. The results were compared with those of the specific red cell adherence test performed on the replicate sections. The two methods showed identical results for isoantigens A, B, and H. Direct immunofluoresence method appeared to be less time-consuming, more simple to perform, and reproducible with less subjectivity in the interpretation of the results.